Comparing Treatments for Malaria in Pregnant Women
Author Information
Author(s): Rose McGready, Saw Oo Tan, Ashley Elizabeth A, Pimanpanarak Mupawjay, Viladpai-nguen Jacher, Phaiphun Lucy, Wüstefeld Katja, Barends Marion, Laochan Natthapon, Keereecharoen Lily, Lindegardh Niklas, Pratap Singhasivanon, White Nicholas J, François Nosten
Primary Institution: Shoklo Malaria Research Unit (SMRU), Mae Sot, Tak, Thailand
Hypothesis
The AL regimen would be superior to AS7 in terms of parasitological efficacy in treating uncomplicated P. falciparum malaria in the second and third trimesters of pregnancy.
Conclusion
The artemether-lumefantrine regimen was safe but less effective than artesunate monotherapy for treating malaria in pregnant women.
Supporting Evidence
- Both treatments were well tolerated with few side effects.
- Cure rates for AS7 were significantly higher than for AL.
- Low drug concentrations in later pregnancy likely contributed to reduced efficacy of AL.
- Infant health outcomes were similar between the two treatment groups.
- One-third of recrudescent infections occurred after 42 days of follow-up.
Takeaway
This study looked at two treatments for malaria in pregnant women and found that one treatment worked better than the other.
Methodology
An open-label randomized controlled trial comparing artemether-lumefantrine and artesunate in pregnant women with uncomplicated malaria.
Potential Biases
Potential bias due to the open-label design and lack of blinding.
Limitations
The study was not blinded, which may have influenced the results.
Participant Demographics
Karen women in the second and third trimesters of pregnancy.
Statistical Information
P-Value
0.031
Confidence Interval
95% CI 82.3%–96.1% for AS7 and 95% CI 74.8%–89.3% for AL
Statistical Significance
p=0.031
Digital Object Identifier (DOI)
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